Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$5,689.01

Service Code	APR-DRG 8101
Min. Negotiated Rate	$5,577.46
Max. Negotiated Rate	$5,689.01
Rate for Payer: UnitedHealthcare Community & State	$5,577.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,689.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5,577.46

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$24,774.53

Service Code	APR-DRG 8104
Min. Negotiated Rate	$24,288.75
Max. Negotiated Rate	$24,774.53
Rate for Payer: UnitedHealthcare Community & State	$24,288.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,774.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24,288.75

HEMORRHOIDAL SUPP

Facility

$4.00

Service Code	NDC 536138912
Hospital Charge Code	6063943317
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

HEMORRHOIDAL SUPP

Facility

$4.00

Service Code	NDC 536138912
Hospital Charge Code	6063943317
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HEMORRHOIDAL SUPPOSITORY

Facility

$4.00

Service Code	NDC 904768822
Hospital Charge Code	60628754
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HEMORRHOIDAL SUPPOSITORY

Facility

$4.00

Service Code	NDC 904768822
Hospital Charge Code	60628754
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

HEMORRHOID ANESTH OINT 28GM

Facility

$34.60

Hospital Charge Code	6002729
Hospital Revenue Code	257
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

HEMORRHOID ANESTH OINT 28GM

Facility

$34.60

Hospital Charge Code	6002729
Hospital Revenue Code	257
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$13.15
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.38
Rate for Payer: Oxford Commercial	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$6.92
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

HEMORRHOID EMOLL OINT 30GM

Facility

$37.80

Hospital Charge Code	6002737
Hospital Revenue Code	257
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$14.36
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.34
Rate for Payer: Oxford Commercial	$7.56
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$7.56
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

HEMORRHOID EMOLL OINT 30GM

Facility

$37.80

Hospital Charge Code	6002737
Hospital Revenue Code	257
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

HEMORRHOIDOPEXY BY STAPLING

Facility

$27,441.80

Service Code	HCPCS 46947
Hospital Charge Code	1600000751
Hospital Revenue Code	360
Min. Negotiated Rate	$4,116.27
Max. Negotiated Rate	$4,116.27
Rate for Payer: Qualcare PPO/HMO/WC	$4,116.27

HEMORRHOIDOPEXY BY STAPLING

Facility

$27,441.80

Service Code	HCPCS 46947
Hospital Charge Code	1600000751
Hospital Revenue Code	360
Min. Negotiated Rate	$661.35
Max. Negotiated Rate	$11,903.20
Rate for Payer: Aetna Commercial	$8,969.36
Rate for Payer: Aetna Medicare Advantage	$10,684.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,903.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,903.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,297.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,903.20
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: Cigna Medicare Advantage	$3,297.56
Rate for Payer: Clover Medicare Advantage	$3,132.68
Rate for Payer: EmblemHealth Commercial	$9,892.68
Rate for Payer: Humana Medicare Advantage	$3,396.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,297.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,232.54
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,116.27
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$661.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,297.56
Rate for Payer: Wellcare Medicare Advantage	$3,297.56
Rate for Payer: Wellpoint Medicaid Managed Care	$727.21

HEMORRHOID PREPARATION/60

Facility

$18.00

Hospital Charge Code	60633081
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

HEMORRHOID PREPARATION/60

Facility

$18.00

Hospital Charge Code	60633081
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

HEMORRHOID STAPLER

Facility

$2,144.17

Hospital Charge Code	270658015
Hospital Revenue Code	272
Min. Negotiated Rate	$321.63
Max. Negotiated Rate	$321.63
Rate for Payer: Qualcare PPO/HMO/WC	$321.63

HEMORRHOID STAPLER

Facility

$2,144.17

Hospital Charge Code	270658015
Hospital Revenue Code	272
Min. Negotiated Rate	$51.67
Max. Negotiated Rate	$1,072.09
Rate for Payer: Aetna Commercial	$814.78
Rate for Payer: Aetna Medicare Advantage	$643.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$546.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$546.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$546.76
Rate for Payer: Cigna Commercial	$1,072.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.25
Rate for Payer: Oxford Commercial	$428.83
Rate for Payer: Qualcare PPO/HMO/WC	$321.63
Rate for Payer: UnitedHealthcare Commercial	$428.83
Rate for Payer: UnitedHealthcare Community & State	$51.67
Rate for Payer: Wellpoint Medicaid Managed Care	$56.82

HEMOSIDERIN,QL,URINE

Facility

$390.00

Service Code	HCPCS 83070
Hospital Charge Code	39900093
Hospital Revenue Code	301
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.75
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.75
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	$3.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HEMOSIDERIN,QL,URINE

Facility

$390.00

Service Code	HCPCS 83070
Hospital Charge Code	39900093
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEMOSIDERIN (QUAL URINE)

Facility

$99.25

Service Code	HCPCS 83070
Hospital Charge Code	3007440
Hospital Revenue Code	301
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: Cigna Medicare Advantage	$4.75
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

HEMOSIDERIN (QUAL URINE)

Facility

$99.25

Service Code	HCPCS 83070
Hospital Charge Code	3007440
Hospital Revenue Code	301
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

HEMOSIDERIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005282
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

HEMOSIDERIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005282
Hospital Revenue Code	310
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$68.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$17.81

HEMOSIDERIN,URINE

Facility

$68.00

Service Code	HCPCS 83070
Hospital Charge Code	38472331
Hospital Revenue Code	301
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$34.00
Rate for Payer: Cigna Medicare Advantage	$4.75
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.80

HEMOSIDERIN,URINE

Facility

$68.00

Service Code	HCPCS 83070
Hospital Charge Code	38472331
Hospital Revenue Code	301
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.20

HEMOSPLIT 27CM

Facility

$1,615.00

Service Code	HCPCS C1750
Hospital Charge Code	270637768
Hospital Revenue Code	278
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) NJ Health	$323.00
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	$390.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$355.30
Rate for Payer: Qualcare PPO/HMO/WC	$242.25
Rate for Payer: UnitedHealthcare Community & State	$38.92
Rate for Payer: Wellpoint Medicaid Managed Care	$42.80

Know your out-of-pocket cost for care.

All Charges