Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEPARIN XA

Facility

$65.00

Hospital Charge Code	38479071
Hospital Revenue Code	305
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

HEPARIN XA

Facility

$65.00

Hospital Charge Code	38479071
Hospital Revenue Code	305
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

HEPATAMINE/500CC

Facility

$389.00

Hospital Charge Code	60634495
Hospital Revenue Code	250
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$194.50
Rate for Payer: Aetna Commercial	$147.82
Rate for Payer: Aetna Medicare Advantage	$116.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.19
Rate for Payer: Cigna Commercial	$194.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.70
Rate for Payer: Oxford Commercial	$77.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.35
Rate for Payer: UnitedHealthcare Commercial	$77.80
Rate for Payer: UnitedHealthcare Community & State	$9.37
Rate for Payer: Wellpoint Medicaid Managed Care	$10.31

HEPATAMINE/500CC

Facility

$389.00

Hospital Charge Code	60634495
Hospital Revenue Code	250
Min. Negotiated Rate	$58.35
Max. Negotiated Rate	$58.35
Rate for Payer: Qualcare PPO/HMO/WC	$58.35

HEPATIC AID

Facility

$71.00

Hospital Charge Code	60634848
Hospital Revenue Code	250
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: Oxford Commercial	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$14.20
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

HEPATIC AID

Facility

$71.00

Hospital Charge Code	60634848
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$24,714.57

Service Code	APR-DRG 2794
Min. Negotiated Rate	$24,229.97
Max. Negotiated Rate	$24,714.57
Rate for Payer: UnitedHealthcare Community & State	$24,229.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,714.57
Rate for Payer: Wellpoint Medicaid Managed Care	$24,229.97

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$6,115.46

Service Code	APR-DRG 2791
Min. Negotiated Rate	$5,995.55
Max. Negotiated Rate	$6,115.46
Rate for Payer: UnitedHealthcare Community & State	$5,995.55
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,115.46
Rate for Payer: Wellpoint Medicaid Managed Care	$5,995.55

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$7,699.83

Service Code	APR-DRG 2792
Min. Negotiated Rate	$7,548.85
Max. Negotiated Rate	$7,699.83
Rate for Payer: UnitedHealthcare Community & State	$7,548.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,699.83
Rate for Payer: Wellpoint Medicaid Managed Care	$7,548.85

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$11,773.83

Service Code	APR-DRG 2793
Min. Negotiated Rate	$11,542.97
Max. Negotiated Rate	$11,773.83
Rate for Payer: UnitedHealthcare Community & State	$11,542.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,773.83
Rate for Payer: Wellpoint Medicaid Managed Care	$11,542.97

HEPATIC FUNCTION A

Facility

$653.80

Service Code	HCPCS 80076
Hospital Charge Code	38472002
Hospital Revenue Code	301
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$326.90
Rate for Payer: Aetna Commercial	$22.22
Rate for Payer: Aetna Medicare Advantage	$26.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.49
Rate for Payer: Cigna Commercial	$326.90
Rate for Payer: Cigna Medicare Advantage	$8.17
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.07
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Medicare Advantage	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.33

HEPATIC FUNCTION A

Facility

$653.80

Service Code	HCPCS 80076
Hospital Charge Code	38472002
Hospital Revenue Code	301
Min. Negotiated Rate	$98.07
Max. Negotiated Rate	$98.07
Rate for Payer: Qualcare PPO/HMO/WC	$98.07

HEPATIC FUNCTION PROFILE

Facility

$1,189.30

Service Code	HCPCS 80076
Hospital Charge Code	3004844
Hospital Revenue Code	301
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$594.65
Rate for Payer: Aetna Commercial	$22.22
Rate for Payer: Aetna Medicare Advantage	$26.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.49
Rate for Payer: Cigna Commercial	$594.65
Rate for Payer: Cigna Medicare Advantage	$8.17
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$178.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Medicare Advantage	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$31.52

HEPATIC FUNCTION PROFILE

Facility

$1,189.30

Service Code	HCPCS 80076
Hospital Charge Code	3004844
Hospital Revenue Code	301
Min. Negotiated Rate	$178.40
Max. Negotiated Rate	$178.40
Rate for Payer: Qualcare PPO/HMO/WC	$178.40

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	HCPCS 90747
Hospital Charge Code	60628304P
Hospital Revenue Code	636
Min. Negotiated Rate	$10.03
Max. Negotiated Rate	$208.03
Rate for Payer: Aetna Commercial	$158.11
Rate for Payer: Aetna Medicare Advantage	$124.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.10
Rate for Payer: Cigna Commercial	$208.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41
Rate for Payer: UnitedHealthcare Community & State	$10.03
Rate for Payer: Wellpoint Medicaid Managed Care	$11.03

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	NDC 58160082111
Hospital Charge Code	60628304
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$100.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	NDC 58160082111
Hospital Charge Code	60628304
Hospital Revenue Code	636
Min. Negotiated Rate	$10.03
Max. Negotiated Rate	$208.03
Rate for Payer: Aetna Commercial	$158.11
Rate for Payer: Aetna Medicare Advantage	$124.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.10
Rate for Payer: Cigna Commercial	$208.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41
Rate for Payer: UnitedHealthcare Community & State	$10.03
Rate for Payer: Wellpoint Medicaid Managed Care	$11.03

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	HCPCS 90747
Hospital Charge Code	60628304P
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$100.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATITIS A ADLT VAC50U/ML INJ

Facility

$510.61

Service Code	NDC 6484100
Hospital Charge Code	60628864
Hospital Revenue Code	250
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$76.59
Rate for Payer: Qualcare PPO/HMO/WC	$76.59

HEPATITIS A ADLT VAC50U/ML INJ

Facility

$510.61

Service Code	NDC 6484100
Hospital Charge Code	60628864
Hospital Revenue Code	250
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$255.31
Rate for Payer: Aetna Commercial	$194.03
Rate for Payer: Aetna Medicare Advantage	$153.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.21
Rate for Payer: Cigna Commercial	$255.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.18
Rate for Payer: Oxford Commercial	$102.12
Rate for Payer: Qualcare PPO/HMO/WC	$76.59
Rate for Payer: UnitedHealthcare Commercial	$102.12
Rate for Payer: UnitedHealthcare Community & State	$12.31
Rate for Payer: Wellpoint Medicaid Managed Care	$13.53

HEPATITIS A (ADULT)

Facility

$171.79

Service Code	HCPCS 90632
Hospital Charge Code	93950065
Hospital Revenue Code	636
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$153.60
Rate for Payer: Aetna Commercial	$65.28
Rate for Payer: Aetna Medicare Advantage	$51.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.81
Rate for Payer: Cigna Commercial	$85.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: Wellpoint Medicaid Managed Care	$4.55

HEPATITIS A (ADULT)

Facility

$171.79

Service Code	HCPCS 90632
Hospital Charge Code	93950065
Hospital Revenue Code	636
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$41.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77

Hepatitis A Antibody, IgM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39888022
Hospital Revenue Code	302
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$124.00
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	$38.40
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	$23.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.52
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	$2.04

Hepatitis A Antibody, IgM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39888022
Hospital Revenue Code	302
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$11.52
Rate for Payer: Qualcare PPO/HMO/WC	$11.52

HEPATITIS A ANTIBODY IGM

Facility

$54.45

Service Code	HCPCS 86709
Hospital Charge Code	3007456
Hospital Revenue Code	302
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$124.00
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	$27.23
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	$16.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
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	$1.44

Know your out-of-pocket cost for care.

All Charges