Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEMOVAC MED *******

Facility

$139.00

Hospital Charge Code	1600519
Hospital Revenue Code	272
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

HEMOVAC MED *******

Facility

$139.00

Hospital Charge Code	1600519
Hospital Revenue Code	272
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.50
Rate for Payer: Aetna Commercial	$52.82
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.45
Rate for Payer: Cigna Commercial	$69.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.70
Rate for Payer: Oxford Commercial	$27.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
Rate for Payer: UnitedHealthcare Commercial	$27.80
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

HEMOVAC UNIVERSAL CONNECTOR***

Facility

$34.00

Hospital Charge Code	1600592
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$17.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.20
Rate for Payer: Oxford Commercial	$6.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$6.80
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

HEMOVAC UNIVERSAL CONNECTOR***

Facility

$34.00

Hospital Charge Code	1600592
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

HEMOVAC WOUND TUBING ******

Facility

$89.00

Hospital Charge Code	1600527
Hospital Revenue Code	272
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

HEMOVAC WOUND TUBING ******

Facility

$89.00

Hospital Charge Code	1600527
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.70
Rate for Payer: Oxford Commercial	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$17.80
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

HEMO WET FIELD ERASER 18G

Facility

$62.00

Hospital Charge Code	270332253
Hospital Revenue Code	272
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$9.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

HEMO WET FIELD ERASER 18G

Facility

$62.00

Hospital Charge Code	270332253
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$31.00
Rate for Payer: Aetna Commercial	$23.56
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.60
Rate for Payer: Oxford Commercial	$12.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.30
Rate for Payer: UnitedHealthcare Commercial	$12.40
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

HENSELAE M

Facility

$70.65

Service Code	HCPCS 86611
Hospital Charge Code	3035072C
Hospital Revenue Code	300
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$27.69
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.75
Rate for Payer: Cigna Commercial	$35.33
Rate for Payer: Cigna Medicare Advantage	$10.18
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Medicare Advantage	$10.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

HENSELAE M

Facility

$70.65

Service Code	HCPCS 86611
Hospital Charge Code	3035072C
Hospital Revenue Code	300
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$10.60
Rate for Payer: Qualcare PPO/HMO/WC	$10.60

HEP A ANTIBODY

Facility

$410.00

Service Code	HCPCS 86709
Hospital Charge Code	38479444
Hospital Revenue Code	302
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.50

HEP A ANTIBODY

Facility

$410.00

Service Code	HCPCS 86709
Hospital Charge Code	38479444
Hospital Revenue Code	302
Min. Negotiated Rate	$9.01
Max. Negotiated Rate	$205.00
Rate for Payer: Aetna Commercial	$30.63
Rate for Payer: Aetna Medicare Advantage	$36.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.65
Rate for Payer: Cigna Commercial	$205.00
Rate for Payer: Cigna Medicare Advantage	$11.26
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.26
Rate for Payer: Wellcare Medicare Advantage	$11.26
Rate for Payer: Wellpoint Medicaid Managed Care	$10.87

HEPALITE ISO=GUARD W/OUT PORT

Facility

$13.50

Hospital Charge Code	270645557
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

HEPALITE ISO=GUARD W/OUT PORT

Facility

$13.50

Hospital Charge Code	27064557
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

HEPALITE ISO=GUARD W/OUT PORT

Facility

$13.50

Hospital Charge Code	270645557
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$5.13
Rate for Payer: Aetna Medicare Advantage	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.44
Rate for Payer: Cigna Commercial	$6.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.05
Rate for Payer: Oxford Commercial	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.70
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

HEPALITE ISO=GUARD W/OUT PORT

Facility

$13.50

Hospital Charge Code	27064557
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$5.13
Rate for Payer: Aetna Medicare Advantage	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.44
Rate for Payer: Cigna Commercial	$6.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.05
Rate for Payer: Oxford Commercial	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.70
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

HEP A PEDS

Facility

$50.00

Service Code	HCPCS 90633
Hospital Charge Code	83652597
Hospital Revenue Code	636
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$79.26
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

HEP A PEDS

Facility

$50.00

Service Code	HCPCS 90633
Hospital Charge Code	83652597
Hospital Revenue Code	636
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$12.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

HEPARIN 1000U/ML INJ 10ML DIAL

Facility

$60.90

Service Code	HCPCS J1644
Hospital Charge Code	60627509
Hospital Revenue Code	636
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.45
Rate for Payer: Aetna Commercial	$23.14
Rate for Payer: Aetna Medicare Advantage	$18.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.53
Rate for Payer: Cigna Commercial	$30.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.13
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

HEPARIN 1000U/ML INJ 10ML DIAL

Facility

$60.90

Service Code	HCPCS J1644
Hospital Charge Code	60627509
Hospital Revenue Code	636
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$14.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.13

HEPARIN 1,000 UNITS/500 ML NS

Facility

$32.23

Service Code	HCPCS J1644
Hospital Charge Code	60627508
Hospital Revenue Code	636
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.11
Rate for Payer: Aetna Commercial	$12.25
Rate for Payer: Aetna Medicare Advantage	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.22
Rate for Payer: Cigna Commercial	$16.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.83
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

HEPARIN 1,000 UNITS/500 ML NS

Facility

$32.23

Service Code	HCPCS J1644
Hospital Charge Code	60627508
Hospital Revenue Code	636
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$7.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.83

HEPARIN 100UNITS/500ML NS

Facility

$465.10

Hospital Charge Code	60635870
Hospital Revenue Code	636
Min. Negotiated Rate	$69.77
Max. Negotiated Rate	$112.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.55
Rate for Payer: Qualcare PPO/HMO/WC	$69.77

HEPARIN 100UNITS/500ML NS

Facility

$465.10

Hospital Charge Code	60635870
Hospital Revenue Code	636
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$232.55
Rate for Payer: Aetna Commercial	$176.74
Rate for Payer: Aetna Medicare Advantage	$139.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.60
Rate for Payer: Cigna Commercial	$232.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.55
Rate for Payer: Qualcare PPO/HMO/WC	$69.77
Rate for Payer: UnitedHealthcare Community & State	$11.21
Rate for Payer: Wellpoint Medicaid Managed Care	$12.33

HEPARIN 100 UNITS/ML INJ

Facility

$45.36

Service Code	NDC 409128031
Hospital Charge Code	60627507
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$22.68
Rate for Payer: Aetna Commercial	$17.24
Rate for Payer: Aetna Medicare Advantage	$13.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.57
Rate for Payer: Cigna Commercial	$22.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.61
Rate for Payer: Oxford Commercial	$9.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.80
Rate for Payer: UnitedHealthcare Commercial	$9.07
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

Know your out-of-pocket cost for care.

All Charges