Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HICKMAN CATHETER

Facility

$378.00

Hospital Charge Code	270335412
Hospital Revenue Code	278
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$91.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$83.16
Rate for Payer: Qualcare PPO/HMO/WC	$56.70

HIGH CONT 1 TO 149 PER ML

Facility

$8.00

Hospital Charge Code	2009380
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HIGH CONT 1 TO 149 PER ML

Facility

$8.00

Hospital Charge Code	2009380
Hospital Revenue Code	255
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

HIGH CONT 200 TO 249 PRML

Facility

$8.00

Hospital Charge Code	2009385
Hospital Revenue Code	255
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

HIGH CONT 200 TO 249 PRML

Facility

$8.00

Hospital Charge Code	2009385
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HIGH CONT 250 TO 299 PRML

Facility

$8.00

Hospital Charge Code	2009390
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HIGH CONT 250 TO 299 PRML

Facility

$8.00

Hospital Charge Code	2009390
Hospital Revenue Code	255
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

HIGH DENSITY LIPOPROTEIN-DIR

Facility

$294.00

Service Code	HCPCS 83718
Hospital Charge Code	38472365
Hospital Revenue Code	301
Min. Negotiated Rate	$6.55
Max. Negotiated Rate	$147.00
Rate for Payer: Aetna Commercial	$22.28
Rate for Payer: Aetna Medicare Advantage	$26.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.56
Rate for Payer: Cigna Commercial	$147.00
Rate for Payer: Cigna Medicare Advantage	$8.19
Rate for Payer: Clover Medicare Advantage	$7.78
Rate for Payer: EmblemHealth Commercial	$24.57
Rate for Payer: Humana Medicare Advantage	$8.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.19
Rate for Payer: Wellcare Medicare Advantage	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$7.79

HIGH DENSITY LIPOPROTEIN-DIR

Facility

$294.00

Service Code	HCPCS 83718
Hospital Charge Code	38472365
Hospital Revenue Code	301
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$44.10
Rate for Payer: Qualcare PPO/HMO/WC	$44.10

HIGH FLOW CARTRIDGE LOW FLOW

Facility

$42,030.00

Hospital Charge Code	270664888
Hospital Revenue Code	270
Min. Negotiated Rate	$6,304.50
Max. Negotiated Rate	$6,304.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50

HIGH FLOW CARTRIDGE LOW FLOW

Facility

$42,030.00

Hospital Charge Code	270664888
Hospital Revenue Code	270
Min. Negotiated Rate	$1,012.92
Max. Negotiated Rate	$21,015.00
Rate for Payer: Aetna Commercial	$15,971.40
Rate for Payer: Aetna Medicare Advantage	$12,609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,717.65
Rate for Payer: Cigna Commercial	$21,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,609.00
Rate for Payer: Oxford Commercial	$8,406.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50
Rate for Payer: UnitedHealthcare Commercial	$8,406.00
Rate for Payer: UnitedHealthcare Community & State	$1,012.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1,113.80

HIGH FLOW CATHETER 5FR X 100CM

Facility

$146.00

Hospital Charge Code	270332314
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

HIGH FLOW CATHETER 5FR X 100CM

Facility

$146.00

Hospital Charge Code	270332314
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$55.48
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Oxford Commercial	$29.20
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$29.20
Rate for Payer: UnitedHealthcare Community & State	$3.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

HIGH-FLOW NASAL CANNULA TX

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	317094660A
Hospital Revenue Code	410
Min. Negotiated Rate	$29.06
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.71
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.85
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$29.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

HIGH-FLOW NASAL CANNULA TX

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	317094660A
Hospital Revenue Code	410
Min. Negotiated Rate	$180.85
Max. Negotiated Rate	$180.85
Rate for Payer: Qualcare PPO/HMO/WC	$180.85

HIGH FREQUENCY CABLE

Facility

$676.50

Hospital Charge Code	270655905
Hospital Revenue Code	271
Min. Negotiated Rate	$101.47
Max. Negotiated Rate	$101.47
Rate for Payer: Qualcare PPO/HMO/WC	$101.47

HIGH FREQUENCY CABLE

Facility

$676.50

Hospital Charge Code	270655905
Hospital Revenue Code	271
Min. Negotiated Rate	$16.30
Max. Negotiated Rate	$338.25
Rate for Payer: Aetna Commercial	$257.07
Rate for Payer: Aetna Medicare Advantage	$202.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.51
Rate for Payer: Cigna Commercial	$338.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.95
Rate for Payer: Oxford Commercial	$135.30
Rate for Payer: Qualcare PPO/HMO/WC	$101.47
Rate for Payer: UnitedHealthcare Commercial	$135.30
Rate for Payer: UnitedHealthcare Community & State	$16.30
Rate for Payer: Wellpoint Medicaid Managed Care	$17.93

HIGH INTENSITY ARC LAMP

Facility

$579.00

Hospital Charge Code	270332550
Hospital Revenue Code	272
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$289.50
Rate for Payer: Aetna Commercial	$220.02
Rate for Payer: Aetna Medicare Advantage	$173.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.65
Rate for Payer: Cigna Commercial	$289.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.70
Rate for Payer: Oxford Commercial	$115.80
Rate for Payer: Qualcare PPO/HMO/WC	$86.85
Rate for Payer: UnitedHealthcare Commercial	$115.80
Rate for Payer: UnitedHealthcare Community & State	$13.95
Rate for Payer: Wellpoint Medicaid Managed Care	$15.34

HIGH INTENSITY ARC LAMP

Facility

$579.00

Hospital Charge Code	270332550
Hospital Revenue Code	272
Min. Negotiated Rate	$86.85
Max. Negotiated Rate	$86.85
Rate for Payer: Qualcare PPO/HMO/WC	$86.85

HIGH/LOW GLUCOSE

Facility

$7.70

Hospital Charge Code	6012637
Hospital Revenue Code	270
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.31
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

HIGH/LOW GLUCOSE

Facility

$7.70

Hospital Charge Code	6012637
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

HIGH/LOW GLUCOSE CONT

Facility

$7.70

Hospital Charge Code	6006308
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

HIGH/LOW GLUCOSE CONT

Facility

$7.70

Hospital Charge Code	6006308
Hospital Revenue Code	270
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.31
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

HIGH MOLECULAR WT KININOG

Facility

$131.25

Service Code	HCPCS 85293
Hospital Charge Code	3032351
Hospital Revenue Code	300
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$51.49
Rate for Payer: Aetna Medicare Advantage	$61.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.33
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: Cigna Medicare Advantage	$18.93
Rate for Payer: Clover Medicare Advantage	$17.98
Rate for Payer: EmblemHealth Commercial	$56.79
Rate for Payer: Humana Medicare Advantage	$19.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.93
Rate for Payer: Wellcare Medicare Advantage	$18.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

HIGH MOLECULAR WT KININOG

Facility

$131.25

Service Code	HCPCS 85293
Hospital Charge Code	3032351
Hospital Revenue Code	300
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

Know your out-of-pocket cost for care.

All Charges