Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HARMONY PRENATAL TEST

Facility

$200.00

Service Code	HCPCS 81599
Hospital Charge Code	3038126
Hospital Revenue Code	310
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

HARMONY PRENATAL TEST

Facility

$200.00

Service Code	HCPCS 81599
Hospital Charge Code	3038126
Hospital Revenue Code	310
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

HARMONY VLED DUAL LIGHT PACKAG

Facility

$110,870.75

Hospital Charge Code	270663228
Hospital Revenue Code	270
Min. Negotiated Rate	$16,630.61
Max. Negotiated Rate	$16,630.61
Rate for Payer: Qualcare PPO/HMO/WC	$16,630.61

HARMONY VLED DUAL LIGHT PACKAG

Facility

$110,870.75

Hospital Charge Code	270663228
Hospital Revenue Code	270
Min. Negotiated Rate	$2,671.99
Max. Negotiated Rate	$55,435.38
Rate for Payer: Aetna Commercial	$42,130.89
Rate for Payer: Aetna Medicare Advantage	$33,261.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,272.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,272.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,272.04
Rate for Payer: Cigna Commercial	$55,435.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33,261.22
Rate for Payer: Oxford Commercial	$22,174.15
Rate for Payer: Qualcare PPO/HMO/WC	$16,630.61
Rate for Payer: UnitedHealthcare Commercial	$22,174.15
Rate for Payer: UnitedHealthcare Community & State	$2,671.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2,938.07

HARVESTER INVASIVE

Facility

$2,975.00

Hospital Charge Code	270687902
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

HARVESTER INVASIVE

Facility

$2,975.00

Hospital Charge Code	270687902
Hospital Revenue Code	272
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.50
Rate for Payer: Oxford Commercial	$595.00
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$595.00
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

HARVESTER LIPIVAGE

Facility

$850.00

Service Code	HCPCS A4649
Hospital Charge Code	270699917
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

HARVESTER LIPIVAGE

Facility

$850.00

Service Code	HCPCS A4649
Hospital Charge Code	270699917
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

HASKAL TIP SET G36126

Facility

$2,976.00

Hospital Charge Code	270635529N
Hospital Revenue Code	272
Min. Negotiated Rate	$71.72
Max. Negotiated Rate	$1,488.00
Rate for Payer: Aetna Commercial	$1,130.88
Rate for Payer: Aetna Medicare Advantage	$892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.88
Rate for Payer: Cigna Commercial	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.80
Rate for Payer: Oxford Commercial	$595.20
Rate for Payer: Qualcare PPO/HMO/WC	$446.40
Rate for Payer: UnitedHealthcare Commercial	$595.20
Rate for Payer: UnitedHealthcare Community & State	$71.72
Rate for Payer: Wellpoint Medicaid Managed Care	$78.86

HASKAL TIP SET G36126

Facility

$3,150.00

Hospital Charge Code	270635529
Hospital Revenue Code	272
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$472.50
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

HASKAL TIP SET G36126

Facility

$3,150.00

Hospital Charge Code	270635529
Hospital Revenue Code	272
Min. Negotiated Rate	$75.92
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.00
Rate for Payer: Oxford Commercial	$630.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Commercial	$630.00
Rate for Payer: UnitedHealthcare Community & State	$75.92
Rate for Payer: Wellpoint Medicaid Managed Care	$83.47

HASKAL TIP SET G36126

Facility

$2,976.00

Hospital Charge Code	270635529N
Hospital Revenue Code	272
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$446.40
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

HASKAL TIP SET G36126

Facility

$3,150.00

Hospital Charge Code	270635529S
Hospital Revenue Code	272
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$472.50
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

HASKAL TIP SET G36126

Facility

$3,150.00

Hospital Charge Code	270635529S
Hospital Revenue Code	272
Min. Negotiated Rate	$75.92
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.00
Rate for Payer: Oxford Commercial	$630.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Commercial	$630.00
Rate for Payer: UnitedHealthcare Community & State	$75.92
Rate for Payer: Wellpoint Medicaid Managed Care	$83.47

HATCHED TITANIUM PROBE KIT

Facility

$2,025.00

Hospital Charge Code	270663190
Hospital Revenue Code	272
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$303.75
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

HATCHED TITANIUM PROBE KIT

Facility

$2,025.00

Hospital Charge Code	270663190
Hospital Revenue Code	272
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.50
Rate for Payer: Oxford Commercial	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Commercial	$405.00
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

HAT URINE COLLECTION SPEC

Facility

$5.65

Hospital Charge Code	270300655
Hospital Revenue Code	270
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

HAT URINE COLLECTION SPEC

Facility

$5.65

Hospital Charge Code	270300655
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

HAV AB,TOTAL

Facility

$390.00

Service Code	HCPCS 86708
Hospital Charge Code	39900247
Hospital Revenue Code	302
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.70
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.72
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.39
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.39
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	$9.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Medicare Advantage	$12.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HAV AB,TOTAL

Facility

$390.00

Service Code	HCPCS 86708
Hospital Charge Code	39900247
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802N
Hospital Revenue Code	278
Min. Negotiated Rate	$439.22
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,009.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$439.22
Rate for Payer: Wellpoint Medicaid Managed Care	$482.96

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802
Hospital Revenue Code	278
Min. Negotiated Rate	$439.22
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,009.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$439.22
Rate for Payer: Wellpoint Medicaid Managed Care	$482.96

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,009.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,009.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One LX

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270677280N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,009.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Know your out-of-pocket cost for care.

All Charges