Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HERCEPTIN 10MG

Facility

$467.07

Hospital Charge Code	60635795
Hospital Revenue Code	636
Min. Negotiated Rate	$70.06
Max. Negotiated Rate	$113.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.03
Rate for Payer: Qualcare PPO/HMO/WC	$70.06

HERCEPTIN 10MG

Facility

$467.07

Hospital Charge Code	60635795
Hospital Revenue Code	636
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$233.53
Rate for Payer: Aetna Commercial	$177.49
Rate for Payer: Aetna Medicare Advantage	$140.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.10
Rate for Payer: Cigna Commercial	$233.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.03
Rate for Payer: Qualcare PPO/HMO/WC	$70.06
Rate for Payer: UnitedHealthcare Community & State	$11.26
Rate for Payer: Wellpoint Medicaid Managed Care	$12.38

HEREDITARY COLON CA DISORDERS1

Facility

$744.90

Service Code	HCPCS 81435
Hospital Charge Code	401181435A
Hospital Revenue Code	310
Min. Negotiated Rate	$111.73
Max. Negotiated Rate	$111.73
Rate for Payer: Qualcare PPO/HMO/WC	$111.73

HEREDITARY COLON CA DISORDERS1

Facility

$744.90

Service Code	HCPCS 81435
Hospital Charge Code	401181435A
Hospital Revenue Code	310
Min. Negotiated Rate	$19.74
Max. Negotiated Rate	$4,706.87
Rate for Payer: Aetna Commercial	$3,546.74
Rate for Payer: Aetna Medicare Advantage	$4,224.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,706.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,706.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,303.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,706.87
Rate for Payer: Cigna Commercial	$372.45
Rate for Payer: Cigna Medicare Advantage	$1,303.95
Rate for Payer: Clover Medicare Advantage	$1,238.75
Rate for Payer: EmblemHealth Commercial	$3,911.85
Rate for Payer: Humana Medicare Advantage	$1,343.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,303.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$467.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,303.95
Rate for Payer: Wellcare Medicare Advantage	$1,303.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

HEREDITARY COLON CA DISORDERS2

Facility

$744.90

Service Code	HCPCS 81436
Hospital Charge Code	401181436B
Hospital Revenue Code	310
Min. Negotiated Rate	$111.73
Max. Negotiated Rate	$111.73
Rate for Payer: Qualcare PPO/HMO/WC	$111.73

HEREDITARY COLON CA DISORDERS2

Facility

$744.90

Service Code	HCPCS 81436
Hospital Charge Code	401181436B
Hospital Revenue Code	310
Min. Negotiated Rate	$17.95
Max. Negotiated Rate	$372.45
Rate for Payer: Aetna Commercial	$283.06
Rate for Payer: Aetna Medicare Advantage	$223.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.95
Rate for Payer: Cigna Commercial	$372.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$128.00

Hospital Charge Code	3035052H
Hospital Revenue Code	301
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$163.60

Hospital Charge Code	3035052A
Hospital Revenue Code	301
Min. Negotiated Rate	$24.54
Max. Negotiated Rate	$24.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.54

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$128.00

Hospital Charge Code	3035052H
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$204.00

Hospital Charge Code	3035052D
Hospital Revenue Code	301
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$111.00

Hospital Charge Code	3035052I
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$204.00

Hospital Charge Code	3035052D
Hospital Revenue Code	301
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$77.52
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.92
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$163.60

Hospital Charge Code	3035052C
Hospital Revenue Code	301
Min. Negotiated Rate	$24.54
Max. Negotiated Rate	$24.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.54

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$163.60

Hospital Charge Code	3035052C
Hospital Revenue Code	301
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$62.17
Rate for Payer: Aetna Medicare Advantage	$49.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.72
Rate for Payer: Cigna Commercial	$81.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.34

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$128.00

Hospital Charge Code	3035052G
Hospital Revenue Code	301
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$204.00

Hospital Charge Code	3035052E
Hospital Revenue Code	301
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$204.00

Hospital Charge Code	3035052E
Hospital Revenue Code	301
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$77.52
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.92
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$111.00

Hospital Charge Code	3035052I
Hospital Revenue Code	301
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.18
Rate for Payer: Aetna Medicare Advantage	$33.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.30
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$163.60

Hospital Charge Code	3035052B
Hospital Revenue Code	301
Min. Negotiated Rate	$24.54
Max. Negotiated Rate	$24.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.54

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$128.00

Hospital Charge Code	3035052G
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$204.00

Hospital Charge Code	3035052F
Hospital Revenue Code	301
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$77.52
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.92
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$163.60

Hospital Charge Code	3035052A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$62.17
Rate for Payer: Aetna Medicare Advantage	$49.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.72
Rate for Payer: Cigna Commercial	$81.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.34

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$163.60

Hospital Charge Code	3035052B
Hospital Revenue Code	301
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$62.17
Rate for Payer: Aetna Medicare Advantage	$49.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.72
Rate for Payer: Cigna Commercial	$81.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.34

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$204.00

Service Code	HCPCS 81256
Hospital Charge Code	3035052
Hospital Revenue Code	310
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$235.93
Rate for Payer: Aetna Commercial	$177.78
Rate for Payer: Aetna Medicare Advantage	$211.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$65.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.93
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: Cigna Medicare Advantage	$65.36
Rate for Payer: Clover Medicare Advantage	$62.09
Rate for Payer: EmblemHealth Commercial	$196.08
Rate for Payer: Humana Medicare Advantage	$67.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$65.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$52.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$65.36
Rate for Payer: Wellcare Medicare Advantage	$65.36
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

HEREDITARY HEMOCHROMATOSIS DNA

Facility

$204.00

Service Code	HCPCS 81256
Hospital Charge Code	3035052
Hospital Revenue Code	310
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

Know your out-of-pocket cost for care.

All Charges